Alveolar Bone Remodeling and Development after Immediate Orthodontic Root Movement

Orthodontic treatment of the adult patient has grown substantially in recent years primarily due to the longevity of natural dentition, an increased awareness of functional benefits of orthodontics and increasing esthetic demands [1]. Compared to the younger patient and in addition to possible malalignment of teeth and jaws, the adult patient will more likely present with a compromised dentition that could include missing teeth, increased wear of teeth along with accompanying periodontal and endodontic involvement. For a complex adult case, careful coordination among disciplines is critically important in order to optimize treatment results [2,3]. In these complex adult clinical situations, orthodontic treatment requires different biomechanical strategies for tooth movement. The crown-tipping mechanics of round wires of older orthodontic systems present treatment challenges for adult non-extraction therapy because these systems can’t rely on growth potential as compared to a younger patient and they are unable to leverage the osteogenic potential of alveolar bone. In 2014, Viazis et al. (4) proposed new, disease-based orthodontic terminology for malpositioned teeth based on the clinical morphology, appearance and contour of the alveolar bone and ridge. This diagnosis, which is called orthodontosis, is defined as the deficiency of the alveolar bone in the horizontal dimension caused by the displaced root(s) of the tooth, typically palatally or lingually. This case report illustrates the successful and efficient utilization of a new technology orthodontic system of braces which facilitates alveolar bone remodeling and development by uprighting the roots of malpostioned teeth immediately at the onset of treatment and with light forces which may simulate natural eruption forces. This action induces alveolar bone remodeling and development horizontally and at approximately the apical one half of the root. The clinical manifestation is the elimination of this noninflammatory deficiency or negative architecture resulting in the correction of malalignment of teeth for esthetic, surgical and restorative purposes.